In the postpartum period, secondary postpartum hemorrhage (SPPH) and endometritis are two conditions that frequently present to an obstetric triage unit. These complications may coexist and can occur from 24 hours postpartum to 6 weeks postdelivery. SPPH is typically not as severe as a primary bleeding episode. Postpartum women ultimately diagnosed with endometritis are generally stable, but less commonly can present in septic shock. This chapter discusses presenting symptomatology, history and data collection, physical examination, laboratory and imaging studies, differential diagnosis, and clinical management and follow-up of secondary postpartum hemorrhage and postpartum endometritis. Prompt treatment of both SPPH and postpartum endometritis can reduce maternal morbidity and mortality. SPPH is managed with the same guiding principles as primary postpartum hemorrhage. Initial treatment for postpartum endometritis is intravenous clindamycin and gentamicin.

Pregnant women presenting with abdominal pain to an emergency department or obstetric triage setting frequently have a diagnostic ultrasound (US) to assess fetus, placenta, and adnexae. In the first trimester, symptomatic adnexal masses typically present with unilateral or bilateral pelvic cramping or pressure. Obtaining a history in a pregnant woman with abdominal pain is similar to doing so for the nonpregnant patient. In addition to routine cardiopulmonary examination, abdominal examination, and assessment for costovertebral angle tenderness, a sterile speculum and vaginal examination are performed to evaluate for adnexal or uterine tenderness, cervical dilation, and potential rupture of membranes. If a mass is suspected, US is the preferred imaging modality. Magnetic resonance imaging can be employed if additional imaging is needed. Differential diagnosis of abdominal pain in pregnant women must include other obstetric and nonobstetric causes of pain. This chapter describes clinical management and follow-up of pregnant women with adnexal masses.

Maternal sepsis is a common pregnancy-related condition; in the United States, it is a leading cause of maternal mortality, accounting for up to 28” of maternal deaths and up to 15” of maternal admissions to the intensive care unit. One contributing and modifiable factor to these deaths is failure to recognize sepsis, leading to delays in treatment. Therefore, rapid and accurate diagnosis and initial management of sepsis in pregnancy in the emergency department (ED) is paramount. Pregnancy poses a unique challenge given the baseline physiologic changes and the need to care for the mother while simultaneously caring for the fetus. Therefore, without clear pregnancy-specific data, recommendations are to follow the current guidelines for nonpregnant adults, yet be cognizant of the ways in which pregnancy may change maternal physiology and affect fetal well-being. Prompt identification and treatment of maternal sepsis will undoubtedly lead to the best possible maternal and neonatal outcomes.

Intimate partner violence (IPV) and sexual assault are common violent crimes perpetrated on women. Obstetric (OB) complications associated with trauma include miscarriage, preterm labor, and placental abruption. Ongoing mental health issues, including depression and anxiety, are more prevalent in pregnant women subjected to any form of IPV, whether or not direct physical violence is involved. One study showed that pregnant women subjected to verbal threats were twice as likely to deliver low-birth-weight infants. All women who present to an OB triage unit or an emergency department (not just those who present with an injury or complication) must be screened for IPV. An organized plan for providing the victim with resources must be readily available when a screen is positive. This chapter discusses presenting symptomatology, history and data collection, physical examination, laboratory and imaging studies, differential diagnosis, clinical management and follow-up care of IPV and sexual assault.

Concurrent with the release of Education and Identity in 1969, the United States was at the nexus of social unrest and expanding funding and support for educational initiatives. The decades of the 1950s and 1960s saw a great increase in research and practice focused on developmental theorists working in the area of higher education. At the forefront of this work was theorist Arthur Chickering. The primary construct of Chickering’s (1969) work is the Seven Vectors of Development. The vectors are: (a) developing competence, (b) managing emotions, (c) moving through autonomy toward interdependence, (d) developing mature interpersonal relationships, (e) establishing identity, (f) developing purpose, and (g) developing integrity. This vector addresses competence across three domains: intellectual, physical and manual, and interpersonal. This chapter briefly outlines Chickering’s life work, and ways in which practitioners can apply his theory to their daily interactions with college students.

Traditionally, there has been a division of labor in higher education between academics and student affairs. This chapter is designed to focus on the plausibility of using theory to facilitate communication across the many departments and divisions of higher education. It is important to remember that the student affairs profession “grew from the campus up, not from theory down”. Early institutions of higher education followed the Oxbridge model with historically based residential living systems in which educators resided in residence halls with the students. This concept of faculty–student integration remains a valuable component in student success today, and is discussed in greater detail in this chapter. One useful “language” for student affairs practitioners is found in Erikson’s stages of psychosocial development. Erik Erikson pioneered a theoretical framework and proposes an eight-staged life-span model through which developing individuals permeate starting at birth and eventually ending with death.

Informal and loosely generated models of White identity development began to emerge in the late 1970s and early 1980s; however, the first formal White identity development model, or typology, was proposed by Helms in 1984. This chapter describes her model, followed by an application of the model to the opening vignette. It identifies strategies for educators and student affairs practitioners to work with students like Craig to begin to more fully understand his Whiteness, the sociopolitical realities of race on campus and, in general, increase his multicultural competence, and engage in healthy interracial interactions. The chapter also discusses the summary of the literature examining the steps educators and student affairs practitioners can take to promote their own cross-cultural interactions and multicultural knowledge in order to more effectively work with students struggling with their own racial identity, followed by the strategies to promote healthy interracial interactions among students.

Holland theorized six distinct worker personalities (Realistic, Investigative, Artistic, Social, Enterprising, and Conventional). This is often referred to as RIASEC. The theory includes six work environments that correspond to the same personality types (Realistic, Investigative, Artistic, Social, Enterprising, and Conventional). Although people possess aspects of each type, the general thesis of the theory is that salient types (work personalities) will emerge in each individual. Holland’s work represents a significant contribution to career development and counseling. Understanding Holland’s focus on interests as expressions of personality aids career counselors and student development specialists in helping students gain critical self-understanding. Exploring the match between personalities and work environments is a fundamental aspect of applying this theory to student development. Helping students to explore and learn about different careers that may be of interest to them is congruent with the goals of higher education institutions and student development theories.

Integral to theories of moral development is the matter of not only what individuals think but also how they think. Across the life span, moral development is shaped by challenging events that prompt individuals to question the frameworks they have created for finding ways to determine what is good and what is bad. College students encounter new ideas and values that differ from those of their families, in the classroom, in the residence hall, in the dining facility, in the student union, and sometimes on the athletic field or court. In order to illustrate how moral development unfolds within a college student population, this chapter introduces a fictitious character who displays each stage of moral development for two theories–Lawrence Kohlberg’s (1963, 1984) and Carol Gilligan’s (1982) models of moral development. The chapter discusses the underpinnings of two specific moral development theories.

Many adults understand the pressures of having multiple responsibilities that require attention in a variety of life circumstances. Whether giving attention to work, friends, school, religious activities, romantic relationships, family, or even recreation, adulthood requires the ongoing ability to multitask a variety of expectations and responsibilities. Before reaching adulthood, each person has experienced influences that affect how we think, feel, and react to life’s circumstances. This chapter offers professionals and educators one model for understanding these influences and their impact on college students who oftentimes are transitioning to a new world of adult responsibilities for the first time. Ecological theory originally developed out of the work of Urie Bronfenbrenner (1977) within the field of developmental psychology. The concepts described in Bronfenbrenner’s ecological theory offer a number of important implications for supporting students in a college setting.